Provider Demographics
NPI:1144774449
Name:YATES, CHARLOTTE (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:
Last Name:YATES
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 COW HOLLOW DR
Mailing Address - Street 2:APT. 2016
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8577
Mailing Address - Country:US
Mailing Address - Phone:704-651-4121
Mailing Address - Fax:
Practice Address - Street 1:6675 COW HOLLOW DR
Practice Address - Street 2:APT. 2016
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8577
Practice Address - Country:US
Practice Address - Phone:704-651-4121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0098991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical